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HomeMy WebLinkAboutBelmont Estates ROW Permit WIO# 20060334 FEE $250.00 � MVEC PAY ❑ MEMBER PAY (check one) EXHiBIT "C" TO PRIOR LAKE PUBLIC WORKS DESIGN MANUAL PERMIT TO WORK WITHIN CITY PROPERTY RIGHT-OF-WAY/EASEMENTS �� AND �CATION FOR INSTALLATION OF UTILITIES D��' �� APPL AUG 2 9 �006 1 Location; Bolmont Eataboa 2. Nature of Work: Install joiut underground uWlitiea-electricai BY 3. Indicate balow ibems to be affectod and include a sketch or plaa of work to be done. [] G�b & Gutt�r ❑ S � � Trail/Sidewalk ❑ Trees: i � Pond/Wetlands ❑ (Publicly owned ❑ ❑ Traffic Control Davioas/Signs ❑ Or Privately owned [�) � �� ❑ Utilities ❑ StructureBuildinga Other Boulevard 4. M,ethod of Installation or Construction Onen trench-ioint S. Wcx'k to start on or after: 9/1/06 and ahall bo cflmpleted b3'- 107 unless an extension grtmbed to: / DATE �� 3TAFF/DATE 6 . Will detourin8 of traffic be necessary? NO 1f necessary to �a�� ��, a�� s�sg�a �: 7. Pro�vide with thie application a copy of the oantractora Public Liability Inaurance. DETOURS: The Dire�tot' of Publi� Works shaU be nc�tified i� �yritinQ at leas�t y2 ho�its=in advsnco of atry detour being estab�hed, c1�an8od or discontinued. NAME OF APPLICANT ''�'`t'`menTe vs�t FY ELE(�TRIC r0 PERATIV�_ PHONE 952-492-231� PT.EASE P�INT . ...,.�n�n nnn� T[1RflAN 1U(Tj 5533:� ADDRESS 5 i � 3TA'rE � 3TREET NAME OF PARTY OR ORGANIZA'TION PERFORMING WORK: �+���_��� CONTACT PERSON: Bob F� EMERGENCY (24 HR.) PHONE#: 952-469-2643 ADDRESS: 10210 235�` 5+��+ ���e MN DAY PHONE 612-3� 0 3TREET, CTfY STATE ZI�' The undeasiBued h�with a� the tams aad cosnditions of this permit bY the CitY of Prior Lake as ha+ein contained ead egroe to fiilly comply therowith to tl�e satisfactioa of the City of Priar Lalce. s�ea: �a-�r-���,�/� n�: snarzuo� : . 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'�pO:t:L��'�i'�'.��i'�'4.0`"p°.�': f � MQ3�ja v�eisi9i�' E � ` �':'v�� ° ��4 : � � ' ,y�3 , ! i I I F � �s�.��;° � � � �r1 r�,�,�. �� "'�' s °`5.� 's `�'c� �� �� �,��_ ' `�- '� ' �� ca.�� �� �n � k.a �����+�'`'�`^'� � '�� . � '��� �� ��` � � ,�.�t il � � ' ♦ + b � x . ,. , , , . _, . . . . . , , ,. , ,r . . > ✓ • - l�Iinnesota Valley Ele�tric Cooperative Strest Light � Autfiorizatioa Form Aut�orization by: �t c� F �2- ��� � Prnject Yarrze: L� ��.,.�.�,�.��-c �S�'�Tc The fallowing li;htin; layout is submitted for your re��iew and approval. The system show;� follows installation ;uidelines typically recommended by your City. If vou authorize the system propos�d on the attached mao, piease indic3te with your - sianature below. If you prefer a modified layout or a different sryie of li�ht. plesse note same on the map indicstins what chan6es you desir�. Plea�e note that the Devz�up�r will normallv be billed tor the installation mate:ials and labor char;es and the City pays for the on;oin; monthly e:cpenses. If you prefer .o handlz the biilinas diffe:�nciv or vou have a spe�ial asre�ment�or unde :SialT�lII? �%I[�1 your devztoper, please indicate your require:nents be(ow: vumber and style of Lights proposed by �NEC: S-/�c��.•• N��- S �€�?�-�► � c �- ISG.... S�p�3�,c r'� G��- �`7 - Vumczr and styte of LiQt�.ts :�uthorized by Cit� Be a�vare that any future requirements to re:ocsce li�hc supporc, or request, ro replac� liahcs wich another sryle will require reimbursemenc for the requested wor�C. �Iso if a pattem of vandalism or dama;e develops. the Cooperadve will contact the Ciry to consider removal, relocation or sgecial aQre�mezc. Ihe City also hereby a�re�s co assist in recoverv ot restitution when facilities are damaQed or vandalized. I hereby a4ree to the installation noted abvve and request tiIVEC to install accordinQ to this asreement: � r Signed by• tiv.0 7�o�o4Zt Position �,� 1� C.. LJ o< k�_ Lo�. � zz .� i c�� or: -�'r� �� LG.�.e--- . . . . . • . � �� � rn � � _ � � � � � � . � � = J� � ' / Z � `� m � � � � p J � b --� - �{ D � i n D � �,. �. ` , r m � m r ,� m ; n g r �� � � - n �O � ' e: ' _ � - �v I � i� � j'� Z � m � : G� � C Z $ '� z � . '� � D ; � i � � i = = m f , � -� i r i � ! � � � i � , : o